HKUMed successfully completed the Southern District Eye Signature Project. The study's findings suggest that tens of thousands of residents across the territory may be living with preventable visual disability. From left: Dr Kendrick Shih Co, Professor Christopher Leung Kai-shun and Dr Zhang Xiujuan.
The Department of Ophthalmology of the School of Clinical Medicine at the LKS Faculty of Medicine of the University of Hong Kong (HKUMed) successfully completed the Southern District Eye Signature Project, a transformative community eye screening initiative supported by HK$45.75 million in government funding through the 'Signature Project Scheme'. This groundbreaking programme examined 21,637 Southern District residents aged 50 or above, revealing that a concerning 27.2% suffer from mild visual impairment – highlighting a hidden public health crisis affecting Hong Kong's ageing population.
The project, launched in May 2019 through an innovative partnership between HKUMed and the Southern District Council, represents the largest community-based eye health assessment ever undertaken in Hong Kong. This unprecedented tripartite collaboration among academic institutions, government bodies and district councils has established a new model for a sustainable community health programme that integrates teaching, research, and community service, creating a win-win situation that further alleviates the burden on the healthcare system.
21,000+ residents receive advanced eye examinations at no cost
The Southern District Eye Signature Project provided no-cost, state-of-the-art eye examinations to 8,307 randomly selected residents and 13,330 self-registered participants from Hong Kong's Southern District. Each participant underwent a comprehensive battery of advanced diagnostic tests, which would typically cost thousands of dollars in private practice, including the following:
- Best corrected visual acuity and intraocular pressure measurements for baseline assessment
- Fundus photography
- ROTA (Retinal Nerve Fiber Layer Optical Texture Analysis) technology for glaucoma detection
- Anterior segment OCT for precise evaluation of cataracts and corneal pathology
- Posterior segment OCT for detailed macular imaging to detect age-related macular degeneration
- Comprehensive clinical examinations by ophthalmologists
Findings expose critical gap in vision care access
The study's findings paint a sobering picture of vision health in Hong Kong. An astounding 27.2% of participants aged 50 or above – were found to have mild visual impairment (presenting visual acuity worse than 20/40) in both eyes. However, this prevalence plummeted to 11.1% with appropriate spectacle correction alone. Of patients with visual impairment not correctable by refractive lenses, 79% were attributable to cataract. The prevalence of blindness, defined as best corrected visual acuity worse than 20/200 in the better eye, stood at 0.2% of the screened population. Critically, the study identified that the two most common causes of reversible visual impairment were uncorrected refractive errors and cataracts – both conditions that can be readily addressed with existing, cost-effective treatments. The project referred 5,843 participants (27.0%) for specialist follow-up care, uncovering substantial undiagnosed eye diseases in the community: 2,564 with vision-disabling cataracts, 2,338 with glaucoma or high-risk glaucoma indicators, and 1,840 with macular or retinal diseases requiring treatment.
'These findings represent a wake-up call for Hong Kong's healthcare system,' said Professor Christopher Leung Kai-shun, Chairperson, Clinical Professor and Albert Bing-Ching Young Professor in Ophthalmology, in Department of Ophthalmology, School of Clinical Medicine, HKUMed. 'The dramatic reduction in visual impairment with simple spectacle correction – from 27.2% to 11.1% — reveals that we are facing not just a medical challenge, but a crisis in access and awareness. Most vision problems afflicting our community are entirely preventable or treatable with basic interventions that have been available for decades.'
Economic and social implications of visual problems
The economic burden of untreated visual impairment extends far beyond healthcare costs. Visual impairment is associated with increased risk of falls, reduced independence, social isolation and accelerated cognitive decline. With Hong Kong's rapidly ageing population, the study's findings suggest that tens of thousands of residents across the territory may be living with preventable visual disability, representing billions in lost productivity and unnecessary healthcare expenditure.
'When nearly half our older population cannot see properly, we are not just talking about a health issue – we are talking about quality of life, independence, and dignity in ageing,' noted Dr Kendrick Co Shih, Clinical Associate Professor of Practice of the Department and Director of the Southern District Community Eye Screening Project. 'This project has shown us that with proper screening and basic interventions, we can transform lives and reduce the burden on families and our healthcare system.'
Dr Shih added, 'In addition to ophthalmologists conducting clinical examinations, our medical students participated, allowing them to interact with the public, developing communication skills and empathy, and enhancing their clinical experience. Furthermore, the programme aims to connect clinical practice with research, education and community care, paving the way for our medical students' future careers.'
Setting new standards for community health initiatives
The Southern District Eye Signature Project has established new benchmarks for community health screening programmes. 'By combining cutting-edge diagnostic technology with community-based delivery, the project achieved remarkable participation rates and generated the most comprehensive dataset on eye health ever compiled in Hong Kong.' said Dr Zhang Xiujuan, Clinical Assistant Professor from the same Department. The initiative's success demonstrates the effectiveness of the Signature Project Scheme model, which allows targeted government funding to empower district councils to address specific local health needs with a lasting impact.
Throughout its operation, the project provided direct clinical services and conducted extensive community education through an eye health lecture series, raising awareness about the importance of regular eye examinations and early intervention. This dual approach of screening and education has created a sustainable model for improving community eye health that can be replicated across Hong Kong and internationally.
About the Southern District Eye Signature Project
The Southern District Eye Signature Project represents an unprecedented partnership between government and academic institutions in community healthcare delivery. With its completion, over 21,000 residents have received comprehensive eye care, which has identified treatable conditions and provided immediate interventions and referrals that have restored sight and transformed lives. The project stands as a testament to what can be achieved when academic excellence, government support, and community engagement converge around the common goal of improving public health.
The Department of Ophthalmology, School of Clinical Medicine, HKUMed, plans to use these findings to advocate for expanded community eye screening programmes, improved access to vision correction services, and enhanced public awareness about the importance of eye examinations throughout Hong Kong.
